Ascension Recovery Services
Payer Contracting Specialist
Ascension Recovery Services, Nashville, Tennessee, United States, 37247
Ascension Recovery Services is currently looking for an experienced payer Contracting & Credentialing Specialist to join our team. The position is 100% remote
Contracting & Credentialing Specialist
Position Overview
The Contracting & Credentialing Specialist is responsible for managing payer contracting and credentialing activities with commercial insurance companies and Medicaid agencies. This role oversees the complete process of provider enrollment, credentialing, and contract execution, ensuring that all applications are submitted accurately and followed through aggressively. The specialist negotiates competitive reimbursement rates while maintaining persistent follow-up to expedite approvals and contract activations.
Key Responsibilities
Prepare, submit, and track contracting paperwork, credentialing applications, and re-credentialing files for all providers and facilities with commercial insurance carriers and Medicaid agencies. Serve as the primary point of contact for credentialing activities, ensuring accuracy, timeliness, and compliance with payer requirements. Monitor credentialing timelines, proactively follow up with payers, and escalate delays to ensure provider participation is secured quickly. Negotiate favorable reimbursement rates and terms with Managed Care Organizations (MCOs) and commercial insurance plans, advocating for optimal financial outcomes. Maintain an organized database of credentialing statuses, contracting progress, rate agreements, and renewal deadlines. Provide regular reports to leadership regarding credentialing completions, contracting progress, and outstanding issues. Develop effective working relationships with payer credentialing and contracting representatives to streamline processes. Stay updated on Medicaid guidelines, NCQA standards, commercial insurer requirements, and industry best practices related to credentialing and contracting. Qualifications
Bachelor's degree in business administration, healthcare management, or related field (preferred). 2+ years of experience in payer contracting and credentialing within healthcare. Proven ability to successfully manage provider credentialing workflows and secure payer enrollments. Demonstrated success in rate negotiations with insurance companies and Medicaid agencies. Strong organizational skills with the ability to manage multiple credentialing files and contracts simultaneously. Excellent communication skills with persistence, assertiveness, and a results-driven approach. Proficiency with Microsoft Office Suite and credentialing/contracting portals. Desired Attributes
Highly detail-oriented with zero tolerance for errors in credentialing documentation. Aggressive and persistent negotiator who follows up promptly until resolutions are achieved. Self-motivated, disciplined, and comfortable in a deadline-driven environment.
Contracting & Credentialing Specialist
Position Overview
The Contracting & Credentialing Specialist is responsible for managing payer contracting and credentialing activities with commercial insurance companies and Medicaid agencies. This role oversees the complete process of provider enrollment, credentialing, and contract execution, ensuring that all applications are submitted accurately and followed through aggressively. The specialist negotiates competitive reimbursement rates while maintaining persistent follow-up to expedite approvals and contract activations.
Key Responsibilities
Prepare, submit, and track contracting paperwork, credentialing applications, and re-credentialing files for all providers and facilities with commercial insurance carriers and Medicaid agencies. Serve as the primary point of contact for credentialing activities, ensuring accuracy, timeliness, and compliance with payer requirements. Monitor credentialing timelines, proactively follow up with payers, and escalate delays to ensure provider participation is secured quickly. Negotiate favorable reimbursement rates and terms with Managed Care Organizations (MCOs) and commercial insurance plans, advocating for optimal financial outcomes. Maintain an organized database of credentialing statuses, contracting progress, rate agreements, and renewal deadlines. Provide regular reports to leadership regarding credentialing completions, contracting progress, and outstanding issues. Develop effective working relationships with payer credentialing and contracting representatives to streamline processes. Stay updated on Medicaid guidelines, NCQA standards, commercial insurer requirements, and industry best practices related to credentialing and contracting. Qualifications
Bachelor's degree in business administration, healthcare management, or related field (preferred). 2+ years of experience in payer contracting and credentialing within healthcare. Proven ability to successfully manage provider credentialing workflows and secure payer enrollments. Demonstrated success in rate negotiations with insurance companies and Medicaid agencies. Strong organizational skills with the ability to manage multiple credentialing files and contracts simultaneously. Excellent communication skills with persistence, assertiveness, and a results-driven approach. Proficiency with Microsoft Office Suite and credentialing/contracting portals. Desired Attributes
Highly detail-oriented with zero tolerance for errors in credentialing documentation. Aggressive and persistent negotiator who follows up promptly until resolutions are achieved. Self-motivated, disciplined, and comfortable in a deadline-driven environment.